Cognitive behavioural therapy

[Leafmaple]

I am 71, have suffered from moderate depression since adolescence.  I exchanged a few messages here a year or so ago.

I would like to ask about the experiences people have had with CBT.  This seems to be all the rage; it seems impossible to find any other form of treatment now, apart from drugs.  I want to emphasize that I do not at all want to discourage anyone from using CBT, and most certainly do not want to destroy anyone's faith in their treatment.  I am very aware that there is a huge body of research that says CBT is effective.  And if it is working or has worked for you, that is great, or if you are thinking about trying it, or are about to start such a program, I would encourage you to do so.  

However, speaking strictly for myself, I tried an online CBT program for depression and gave up halfway through.  I had read a fair bit about CBT beforehand, and was skeptical, because I could not see how it could possibly work for me.  Also, in my pre-retirement life, I was an academic and learned to skeptical about some research, where everyone jumps on a certain wagon for a while, so had doubts about the validity of some of the research.   But at the same time, as everyone here knows, depression is no fun, and I was ready to try it, despite my skepticism.  I gave up primarily because I felt I was being encouraged to tell myself lies, to convince myself that what I know to be true is not true.  I realize that some thoughts are not helpful, but that doesn't mean they are not true.  From the outside my life seems successful; to me, from the inside, it has been a waste and a failure.  That is not a helpful thought, no doubt about that, but it is true, feels true too, and thousands of concrete experiences have proved it to me; every social interaction with a stranger proves it to me.  Telling myself it is not true seems like the height of foolishness to me, would be like trying to convince myself that 2 + 2 = 5.

When I was last here, someone mentioned finding success with a group CBT treatment.  I can't see how that would work either.  However, I would be grateful if anyone wanted to talk about how CBT, either in a group or not, was helpful to them.  I am not asking because I want to attack anyone's treatment, but hopefully to understand how CBT has helped others.  Thanks.

[JessF]

Hello Leafmaple, I know what you mean. I found some of the CBT tools useful, but I think if you have a more deep seated or long lasting depression, CBT perhaps doesn't quite cut it.  I get the feeling its more for people with mild to moderate depression.

If you are constantly feeling that the perceptions of your outer life don't match your inner life, then you might benefit more from a kind of therapy that digs deeper into why you have these perceptions in the first place.  Within the last couple of years I tried a different kind of therapy called schema therapy that looks more into your history and patterns that have occurred throughout your life to help identify what your triggers are.

While CBT at its most basic will tell you, x is a false feeling, when you dig deeper with things like schema therapy or psychoanalysis you can start to pinpoint where a feeling of inadequacy for example might have originally come from. Recognising that a current feeling is not so current but an echo of something past goes a long way to defusing it.

Another type of therapy that I found most useful for me was ACT or acceptance and commitment therapy. It teaches you more about living with uncomfortable feelings rather than trying to 'rewrite' them as CBT does.

Have you tried any other types of therapy?

[Leafmaple]

Hi Jess.  Thanks for answering.  I have not heard of either schema therapy or ACT, so will look for information on both tomorrow.  They both sound very interesting.  How does schema therapy differ from what a psychiatrist does in traditional "talking" therapy?  And what do you commit to in ACT?  I don't mean you specifically.  I guess I don't understand how that works.  In a sense, I have partially accepted that I am this failed person, but the result is that I have restricted all social interaction to my family; anything ourtside my family I keep to only what is absolutely necessary, which means very little.

As as for other therapies, I saw a psychiatrist for one visit at a university health service when I was vaguely 21, but he was so unfriendly that I never went back.  In the 1990s I spent more then 3 years seeing a psychiatrist.  He was excellent, I learned a lot about where some of my behavioural patterns come from.  As you say, they are not new; they came from genetics, upbringing, nature and nature.  But I was unable to change, or only able to change marginally, so I wonder just how "false" the negative views are.  Obviously, you have a different experience of all this, which is good.  Thank you for giving me ideas and things to pursue.

[Bipolar4Lyf]

I also tried online and apps for CBT that just did not work for me. I hated sitting there with my own thoughts. However, when I eventually did CBT with a psychologist, it made such a huge difference in certain situations and years later, I still use the tools that I was taught. I now see a psychiatrist who deals with my meds and is very happy with the CBT skills that I have already learned.